title: Serum vitamin level maintenance in cancer patients on total parenteral nutrition.
abstract: The quantity of water and fat soluble vitamins required to maintain serum levels in cancer patients on total parenteral nutrition (TPN) has yet to be determined. A prospective evaluation of our current intravenous vitamin regimen during TPN was performed in order to define these requirements. Seventy-five patients receiving 97 TPN courses for seven to 60 days were studied. Serum levels of vitamins A (74 courses), B12 (85), folate (62), C (97), and 25-OH-cholecalciferol (25-OH-D) (9) were available for analysis. Daily vitamin intakes were recorded and serum levels were determined weekly. Restoration and maintenance of normal mean serum vitamin levels were achieved for all but 25-OH-D. However, analysis of individual courses in previously depleted patients revealed that serum levels were not restored in three patients (4%) for vitamin A and six patients (66%) for 25-OH-D. A TPN regimen designed to provide the following weekly vitamin quantities: A: 21,000 IU, D: 2100 IU, C: 3500 mg, B12: 126 micrograms, and folate: 7 mg will maintain mean serum vitamin levels for all but 25-OH-D. This regimen has the ability to uniformly restore and maintain vitamins B12, C, and folate in all patients but not in those patients previously deficient in vitamins A and D.
mesh_terms: D000328:Adult; D001205:Ascorbic Acid / Q000008:administration & dosage; D002112:Calcifediol; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009751:Nutritional Requirements; D010288:Parenteral Nutrition / Q000592:standards*; D010289:Parenteral Nutrition, Total / Q000592:standards*; D014801:Vitamin A / Q000008:administration & dosage; D014805:Vitamin B 12 / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood*
chemical_list: D006887:Hydroxycholecalciferols; D014815:Vitamins; D014801:Vitamin A; D005492:Folic Acid; D014805:Vitamin B 12; D002112:Calcifediol; D001205:Ascorbic Acid